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Post-operative Outcome during Off-Pump Coronary Artery Bypass Surgery – A Comparison between Combined High Thoracic Epidural Anaesthesia with General Anaesthesia and General Anaesthesia Alone 非体外循环冠状动脉搭桥手术的术后结果——胸廓高位硬膜外联合全身麻醉与单纯全身麻醉的比较
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61912
Saiful Islam Azad, S. Alam, Abdul Khaleque Beg
Background: In the postoperative period inadequate analgesia may increase morbidity by causing adverse haemodynamic, metabolic, immunologic and haemostatic attentions and prolong mechanical ventilation with more ICU stay. This study has been undertaken to compare postoperative outcome in off-pump coronary artery bypass surgery (OPCAB) between high thoracic epidural anaesthesia (HTEA) as an adjunct to general anaesthesia (GA) vs. GA alone.Methods : This prospective, randomized case control comparative study was carried out in sixty patients without having left main coronary artery disease, left ventricular ejection fraction <30% or contraindication of regional anaesthesia scheduled for OPCAB. They were divided into two groups, thirty in each group. Group A received GA alone and group B received high thoracic epidural anaesthesia with GA. Requirement of postoperative analgesics, pain score, sedation score, and post-operative complications were evaluated. Results: Rescue analgesics was needed in 16 (53.3%) and 6 (20.0%) patients in group A and group B respectively (p<0.05). Post-operative pain score (VAS) during maintenance with ventilator with awareness at first fourth hour and after extubation during movement & cough were significantly different between two groups. Post-operative sedation score was significantly different between two groups except in 1st hour. No post-operative complication was observed in both groups.Conclusion: High thoracic epidural anaesthesia with GA appeared to be most reliable postoperative pain reliever with better post-operative outcome in OPCAB surgery.Cardiovasc j 2022; 15(1): 63-68
背景:术后不适当的镇痛可引起不良的血流动力学、代谢、免疫和止血反应,延长机械通气时间,延长ICU住院时间,从而增加发病率。本研究比较了非体外循环冠状动脉搭桥手术(OPCAB)中高位胸段硬膜外麻醉(HTEA)辅助全身麻醉(GA)与单纯全身麻醉(GA)的术后结果。方法:本前瞻性、随机病例对照比较研究纳入60例无左主干冠状动脉疾病、左室射血分数<30%、无OPCAB局部麻醉禁忌症的患者。他们被分成两组,每组30人。A组单用GA, B组加GA高位胸硬膜外麻醉。评估术后镇痛药需求、疼痛评分、镇静评分及术后并发症。结果:A组16例(53.3%),B组6例(20.0%)需使用抢救镇痛药(p<0.05)。两组患者术后第4小时呼吸机维持及清醒时疼痛评分(VAS)及拔管后运动及咳嗽时疼痛评分差异有统计学意义。两组术后镇静评分除1 h外,差异有统计学意义。两组均无术后并发症。结论:在OPCAB手术中,胸椎高位硬膜外麻醉加GA是最可靠的术后镇痛药,术后疗效较好。心血管病杂志[j] 2022;15 (1): 63 - 68
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引用次数: 0
Renal Cell Carcinoma with Inferior Vena Cava Thrombus: A Case Report 肾细胞癌合并下腔静脉血栓1例
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61921
M. Anisuzzaman, N. Hosain, Zulfiqar Rashid
The incidence of venous extension to the inferior vena cava (IVC) of renal cell carcinoma (RCC) is markedly increased recently mostly due to the advances in diagnostic modalities. Such vascular invasion implies a heightened biologic behavior and a surgical challenge during the course of treatment. Here we discussed a case with study of the classification guidelines, recent diagnostic tools and up-to-date therapeutic modalities for RCC with IVC tumor thrombi. Also added to the discussion are the prognostic significance regarding the pathologic nature of vascular invasion, cephalad extent of thrombi and any associated distant metastasis.Cardiovasc j 2022; 15(1): 111-115
肾细胞癌(RCC)的静脉延伸至下腔静脉(IVC)的发生率近年来显著增加,主要是由于诊断方式的进步。这种血管侵犯意味着在治疗过程中生物行为的提高和手术的挑战。在这里,我们讨论了一个病例,研究了分类指南,最新的诊断工具和最新的治疗方法,用于肾小球细胞癌合并下腔静脉肿瘤血栓。此外,还讨论了血管侵犯的病理性质、血栓的头部范围和任何相关的远处转移的预后意义。心血管病杂志[j] 2022;15 (1): 111 - 115
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引用次数: 0
Delayed Surgical Repair of Ventricular Septal Rupture with CABG following Acute Myocardial Infraction- A Case Report 急性心肌梗死后冠脉搭桥延迟手术修复室间隔破裂1例报告
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61919
Sultan Sarwar Parvez, M. R. Amin, Reazul Haque, Jalal Uddin
Ventricular septal rupture (VSR) is a rare but often life-threatening mechanical complication after acute myocardial infarction. Although surgical intervention is challenging and associated with high mortality and morbidity, but it is still now the gold standard treatment. Percutaneous device closure of VSR is an option in selected patients with suitable anatomy and when surgery is contraindicated. Optimally medically managed patients who survive at least 4 weeks before elective surgery to generate scar formation at the edges of the defect in a viable infarcted tissue have the greatest outcomes. Here we report a case of VSR following acute myocardial infarction. About 3 weeks after the occurrence of ventricular septal rupture following acute myocardial infraction, surgery was successfully performed with good outcome.Cardiovasc j 2022; 15(1): 100-105
室间隔破裂是急性心肌梗死后一种罕见但常危及生命的机械并发症。尽管手术干预具有挑战性,且与高死亡率和发病率相关,但它仍然是目前治疗的金标准。经皮装置关闭的VSR是一个选择的病人有合适的解剖和手术禁忌。在可存活的梗死组织的缺损边缘形成疤痕的择期手术前存活至少4周的经最佳医学管理的患者有最好的结果。我们在此报告一例急性心肌梗死后的VSR。急性心肌梗死后室间隔破裂约3周后手术成功,预后良好。心血管病杂志[j] 2022;15 (1): 100 - 105
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引用次数: 0
Mechanical Circulatory Support: Historical Perspective 机械循环支持:历史的观点
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61914
M. Anisuzzaman, N. Hosain, Mohammad Rafiur Rahman
Abstract not availableCardiovasc j 2022; 15(1): 75-80
[摘要]心内科杂志[j] 2022;15 (1): 75 - 80
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引用次数: 0
A Case of Giant Right Coronary Artery Aneurysm after DES Implantation DES植入术治疗巨大右冠状动脉瘤1例
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61917
M. A. K. Akanda, M. Ullah, M. Rahman, Md Sarwar Alam, Amiruzzaman Khan
Coronary artery aneurysms (CAAs) are not very uncommon but giant coronary artery aneurysms are rare with a reported prevalence of 0.02% to 0.2%. Recently, with the advent of implantation of drugeluting stents, there are increasing reports suggesting stents causing coronary aneurysms, months or years after the procedure. Though most of the CAAs are asymptomatic, they may present with various clinical presentations like angina pectoris, fistula formation, pericardial tamponade, compression of surrounding structures, congestive cardiac failure or sudden death. The natural history and prognosis remain unclear. Despite the important anatomical abnormality of the coronary artery, the treatment options of CAAs are still poorly defined and present a therapeutic challenge. We report a case of iatrogenic giant CAA following percutaneous transluminal coronary angioplasty (PTCA) with its relevant management strategy.Cardiovasc j 2022; 15(1): 88-94
冠状动脉瘤(CAAs)并不罕见,但巨冠状动脉瘤很少见,据报道患病率为0.02%至0.2%。最近,随着药物支架植入的出现,越来越多的报道表明支架在手术后数月或数年引起冠状动脉瘤。虽然大多数caa是无症状的,但它们可能会出现各种临床表现,如心绞痛、瘘管形成、心包填塞、周围结构受压、充血性心力衰竭或猝死。自然病史和预后仍不清楚。尽管冠状动脉存在重要的解剖异常,但CAAs的治疗选择仍然不明确,并且存在治疗挑战。我们报告一例经皮腔内冠状动脉成形术(PTCA)后的医源性巨大CAA及其相关的处理策略。心血管病杂志[j] 2022;15 (1): 88 - 94
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引用次数: 0
Replantation of an Amputated Hand- A Landmark surgery with Multidisciplinary Team Approach 断肢再植-多学科团队方法的里程碑式手术
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61920
A. S. Islam, Aym Shahidullah, M. Mostofa, Md Daud Hossain
An amputation of the hand is a disastrous traumatic injury especially for advanced machinery workers which adversely affects the victim’s ability to earn a livelihood, support a family, and carry out daily activities. It also produces great psychological impact. In the following case report, we described a middleaged male with an amputation at the level of the distal forearm who underwent replantation. The transfer of the amputated hand, operative technique and postoperative status are described. Awareness of the possibility of salvage should be spread among healthcare providers and the need for immediate attention by a multispecialty team is advocated. This report reviews the literature related to the operative technique, contraindications and long-term results.Cardiovasc j 2022; 15(1): 106-110
手部截肢是一种灾难性的创伤性伤害,特别是对高级机械工人来说,它对受害者谋生、养家和日常活动的能力产生不利影响。它还会产生巨大的心理影响。在以下病例报告中,我们描述了一位在前臂远端截肢的中年男性,他接受了再植。本文介绍了截肢手的移植、手术技术及术后情况。应在医疗保健提供者中传播抢救可能性的意识,并提倡由多专业团队立即关注。本报告回顾了有关手术技术、禁忌症和远期疗效的文献。心血管病杂志[j] 2022;15 (1): 106 - 110
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引用次数: 0
Association of Troponin-I Level with Left Ventricular Systolic Dysfunction after First Episode of Non- ST Elevation Myocardial Infarction 非ST段抬高型心肌梗死首次发作后肌钙蛋白- 1水平与左室收缩功能障碍的关系
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61909
Md Shariful Islam, Abdul Kader Akanda, M. Ullah, Md Gulam Mostafa, Md Zillur Rahman, Mohammad Mamoon Islam
Background: Serum troponin is an exquisitely sensitive marker of myocardial injury and is necessary for establishing the diagnosis of Myocardial Infarction particularly non-ST elevation myocardial infarction (NSTEMI). However, the relation of troponin-I level with left ventricular systolic dysfunction following first episode of NSTEMI are still not examined in our population. Therefore, to determine the relationship of serum troponin I with left ventricular ejection fraction after first episode of NSTEMI was set as an objective of the study.Methods: This cross sectional analytical study was conducted on 160 patients. They were divided into the two groups (80 patients in each group): Group-A (Troponin I level e” 0.4 ng/ml) high risk group and Group-B (Troponin I level < 0.4 ng/ml) low risk group. Left ventricular systolic dysfunction was defined as ejection fraction (EF%) < 50% calculated by modified Simpson’s method on transthoracic echocardiography. Association of troponin-I level with left ventricular systolic function was determined.Results: Among a total 160 patients, no significant variation across the group A and B in terms of age, gender and occupation (p>0.05 in all cases). Median serum troponin I of group A was 7.24 (range: 0.41- 58.25) and group B was 0.21(range: 0.12-0.39). Left ventricular EF was significantly lower in higher troponin I group (Group A-45.95±10.28 vs. Group B-56.30±7.78; p<0.05) and it was associated with higher proportion of left ventricular dysfunction (p<0.05).Conclusion: Serum troponin-I can be considered as a predictor of the left ventricular systolic dysfunction in first episode of Non-ST elevation myocardial infarction patients.Cardiovasc j 2022; 15(1): 42-48
背景:血清肌钙蛋白是一种非常敏感的心肌损伤标志物,对于确定心肌梗死特别是非st段抬高型心肌梗死(NSTEMI)的诊断是必要的。然而,在我们的人群中,肌钙蛋白- 1水平与NSTEMI首次发作后左心室收缩功能障碍的关系仍未被研究。因此,确定NSTEMI首次发作后血清肌钙蛋白I与左室射血分数的关系是本研究的目的。方法:对160例患者进行横断面分析研究。将患者分为两组(每组80例):a组(肌钙蛋白I水平为0.4 ng/ml)高危组和b组(肌钙蛋白I水平< 0.4 ng/ml)低危组。经胸超声心动图改良Simpson法计算射血分数(EF%) < 50%为左室收缩功能不全。测定肌钙蛋白- 1水平与左心室收缩功能的关系。结果:160例患者中,a、B组在年龄、性别、职业等方面无显著差异(均p>0.05)。A组血清肌钙蛋白I中位数为7.24(范围:0.41 ~ 58.25),B组为0.21(范围:0.12 ~ 0.39)。高肌钙蛋白I组左室EF明显降低(a组45.95±10.28∶b组56.30±7.78;P <0.05),且伴有较高的左心功能不全比例(P <0.05)。结论:血清肌钙蛋白- 1可作为非st段抬高型心肌梗死患者首发左室收缩功能障碍的预测指标。心血管病杂志[j] 2022;15 (1): 42-48
{"title":"Association of Troponin-I Level with Left Ventricular Systolic Dysfunction after First Episode of Non- ST Elevation Myocardial Infarction","authors":"Md Shariful Islam, Abdul Kader Akanda, M. Ullah, Md Gulam Mostafa, Md Zillur Rahman, Mohammad Mamoon Islam","doi":"10.3329/cardio.v15i1.61909","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61909","url":null,"abstract":"Background: Serum troponin is an exquisitely sensitive marker of myocardial injury and is necessary for establishing the diagnosis of Myocardial Infarction particularly non-ST elevation myocardial infarction (NSTEMI). However, the relation of troponin-I level with left ventricular systolic dysfunction following first episode of NSTEMI are still not examined in our population. Therefore, to determine the relationship of serum troponin I with left ventricular ejection fraction after first episode of NSTEMI was set as an objective of the study.\u0000Methods: This cross sectional analytical study was conducted on 160 patients. They were divided into the two groups (80 patients in each group): Group-A (Troponin I level e” 0.4 ng/ml) high risk group and Group-B (Troponin I level < 0.4 ng/ml) low risk group. Left ventricular systolic dysfunction was defined as ejection fraction (EF%) < 50% calculated by modified Simpson’s method on transthoracic echocardiography. Association of troponin-I level with left ventricular systolic function was determined.\u0000Results: Among a total 160 patients, no significant variation across the group A and B in terms of age, gender and occupation (p>0.05 in all cases). Median serum troponin I of group A was 7.24 (range: 0.41- 58.25) and group B was 0.21(range: 0.12-0.39). Left ventricular EF was significantly lower in higher troponin I group (Group A-45.95±10.28 vs. Group B-56.30±7.78; p<0.05) and it was associated with higher proportion of left ventricular dysfunction (p<0.05).\u0000Conclusion: Serum troponin-I can be considered as a predictor of the left ventricular systolic dysfunction in first episode of Non-ST elevation myocardial infarction patients.\u0000Cardiovasc j 2022; 15(1): 42-48","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84123743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revascularization Failure: Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting 血运重建失败:经皮冠状动脉介入治疗或冠状动脉旁路移植术
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61915
A. Islam, A. Reza, S. Munwar, S. Talukder
Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity in our Bangladeshi patient population. Percutaneous coronary intervention (PCI) or Coronary artery bypass grafting (CABG) are the gold standard of revascularization to treat these group of patients. Both treatment modalities may contribute to both short term and long-term excellent benefit with the relief of symptoms and improves quality of life. Beside the availability of modern techniques along with 3rd generation Drug eluting stents (DES) for PCI and uses of arterial conduit in bypass surgery, in long-term follow-up, many of the patient needs repeat revascularization. In Bangladesh, many of the centers are doing state of the art treatment with the available of most of interventional aids in treating complex PCI as well as primary PCI. Similarly, CABG with the advent and available expertise, minimal invasive bypass surgery or beating heart surgery, facilitate CABG more convenient for patient and surgeons as well. Exact data on stent occlusion or graft failure that may leads to repeat revascularization is not well understood in our circumstances. We need to form a common consensus, if needed, to form a national registry or database to follow up PCI or CABG patients who develop subsequent revascularization failure and address the reason behind. Thus, to reduce the needs of repeat revascularization and improve long term quality of life.Cardiovasc j 2022; 15(1): 81-85
冠状动脉疾病(CAD)是导致孟加拉国患者死亡和发病的主要原因之一。经皮冠状动脉介入治疗(PCI)或冠状动脉旁路移植术(CABG)是治疗这类患者血运重建术的金标准。这两种治疗方式都可能有助于缓解症状和提高生活质量的短期和长期的良好效益。除了现代技术的可用性以及第三代药物洗脱支架(DES)用于PCI和旁路手术中动脉导管的使用,在长期随访中,许多患者需要重复血运重建术。在孟加拉国,许多中心正在进行最先进的治疗,在治疗复杂的PCI和初级PCI方面,大多数介入辅助设备都是可用的。同样,CABG的出现和现有的专业技术,微创搭桥手术或心脏跳动手术,使CABG对患者和外科医生都更方便。在我们的情况下,可能导致重复血运重建的支架闭塞或移植物失败的确切数据尚不清楚。如果需要的话,我们需要形成一个共识,建立一个全国性的登记或数据库,对PCI或CABG患者进行后续血运重建失败的随访,并找出其背后的原因。从而减少重复血运重建的需要,提高长期生活质量。心血管病杂志[j] 2022;15 (1): 81 - 85
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引用次数: 0
Heart Failure in Geriatric Patients 老年心力衰竭患者
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61903
A. Majumder
Abstract not availableCardiovasc j 2022; 15(1): 1-3
[摘要]心内科杂志[j] 2022;15 (1): 1 - 3
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引用次数: 0
Analysis of Risk Factors among the Hypertensive Patients in a Tertiary Care Hospital of a Northern District in Bangladesh 孟加拉国北部地区某三级医院高血压患者危险因素分析
Pub Date : 2022-10-10 DOI: 10.3329/cardio.v15i1.61913
Md Saiduzzaman, Md. Shahriar Kabir, Asmg Rabbani, Md Abdul Matin, Md. Rezaul Alam, Khandaker Abu Rubaiyat, Md Mamun Reza
Background: Hypertension is the leading cause of cardiovascular morbidity and mortality all over the world. Although some epidemiological studies on hypertension have been conducted in Bangladesh, the factors associated with hypertension in this nation remain unclear. The objective of this study was to determine the factors associated with hypertension among the adult population in a northern district in Bangladesh.Methods: This cross- sectional study was conducted at the Department of Cardiology, M. Abdur Rahim Medical College Hospital, Dinajpur from March 2021 to February 2022. Out of total of 500 participants from OPD and indoor Cardiology Department of this hospital, 250 hypertensive patients were recruited as cases and another 250 normotensive participants were taken as control.Results: Majority of the hypertensive patients in the study population were in 46-55 years of age group [male 48(32.4%) and female 40(39.2%)]; whereas normotensive participants less in number in the same age group [male 20(16.1%) and female 24(19.0%)]. Hypertension was more common in males (59.2% of cases). Moreover, hypertensive participants had strong family history (66%) of hypertension, urban residential area (68%), habits of smoking (67.2%), diabetes mellitus (64%), and excess salt consumption (70%). Raised levels of total cholesterol, triglycerides, and LDL were more common among hypertensive participants than that of the normotensive control group and which was found to be statistically significant.Conclusion: Our study shows that the risk of hypertension was significantly associated with older age, male sex, family history of hypertension, urban residence, smoking, excess salt consumption, higher BMI and waist circumference, dyslipidemia and diabetes mellitus. More studies and area-specific longitudinal research is needed in this field which would help adopt national policies to limit incidence as well as consequences of hypertension in our country.Cardiovasc j 2022; 15(1): 69-74
背景:高血压是全世界心血管疾病发病和死亡的主要原因。尽管在孟加拉国进行了一些关于高血压的流行病学研究,但与该国高血压相关的因素仍不清楚。本研究的目的是确定孟加拉国北部地区成人高血压的相关因素。方法:本横断面研究于2021年3月至2022年2月在迪纳杰普尔M. Abdur Rahim医学院医院心内科进行。在该院门诊和室内心内科共500名受试者中,250名高血压患者作为病例,250名正常受试者作为对照组。结果:研究人群中高血压患者以46 ~ 55岁年龄组居多[男性48例(32.4%),女性40例(39.2%)];而在同一年龄组中,血压正常的受试者人数较少[男性20人(16.1%),女性24人(19.0%)]。高血压以男性多见(59.2%)。此外,高血压患者有高血压家族史(66%)、城市居住地区(68%)、吸烟习惯(67.2%)、糖尿病(64%)和过量盐摄入(70%)。总胆固醇、甘油三酯和低密度脂蛋白水平升高在高血压参与者中比正常对照组更常见,这在统计学上是显著的。结论:我们的研究表明,高血压风险与年龄、男性、高血压家族史、城市居住、吸烟、过量盐摄入、高BMI和腰围、血脂异常和糖尿病有显著相关性。在这一领域需要更多的研究和特定区域的纵向研究,这将有助于制定国家政策来限制我国高血压的发病率和后果。心血管病杂志[j] 2022;15 (1): 69 - 74
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引用次数: 0
期刊
Cardiovascular Journal
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